Provider Demographics
NPI:1841423274
Name:THE HEARING HEALTH CARE CENTER OF MANASSAS, INC.
Entity type:Organization
Organization Name:THE HEARING HEALTH CARE CENTER OF MANASSAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-369-0300
Mailing Address - Street 1:8650 SUDLEY RD STE 209
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4416
Mailing Address - Country:US
Mailing Address - Phone:703-369-0300
Mailing Address - Fax:703-369-0017
Practice Address - Street 1:8650 SUDLEY RD STE 209
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4416
Practice Address - Country:US
Practice Address - Phone:703-369-0300
Practice Address - Fax:703-369-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000555231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty